摘要
目的分析重症肺炎患者血清CD40配体(CD40L)、血管细胞黏附分子-1(VCAM-1)和可溶性髓系细胞触发受体-1(sTREM-1)水平与病情和预后的关系.方法选取90例重症肺炎患者为研究对象,按入院时急性生理与慢性健康(APACHEⅡ)评分分为低危组(n=22,APACHEⅡ评分<10分)、中危组(n=43,APACHEⅡ评分10~20分)及高危组(n=25,APACHEⅡ评分>20分);选取同期进行体检的30例健康者作为对照组,随访3个月,根据预后分为存活组(n=53)和死亡组(n=37);检测血清CD40L、VCAM-1和sTREM-1水平,采用ROC曲线分析其水平对预后的评估价值.结果高危组血清CD40L、VCAM-1和sTREM-1水平高于低危组和中危组,中危组血清CD40L、VCAM-1和sTREM-1水平高于低危组(P<0.05);死亡组血清CD40L、VCAM-1和sTREM-1水平高于生存组(P<0.05);多因素Logistic回归分析显示:血清CD40L、VCAM-1和sTREM-1水平是影响重症肺炎患者预后的危险因素(P<0.05);ROC曲线分析显示:血清CD40L、VCAM-1和sTREM-1水平联合预测重症肺炎患者预后的敏感度及特异度均高于单独预测(P<0.05).结论重症肺炎患者血清CD40L、VCAM-1和sTREM-1水平是影响重症肺炎患者预后的危险因素,可作为判断患者病情和评估预后的参考指标.
Objective To analyze the relationship between serum CD40 ligand(CD40L),vascular cell adhesion molecule-1(VCAM-1),soluble triggering receptor expressed on myeloid cells-1(sTREM-1)levels and conditions,prognosis of patients with severe pneumonia.Method Ninety patients with severe pneumonia were enrolled as the research objects.According to different scores of acute physiology and chronic health evaluationⅡ(APACHEⅡ)at admission,they were divided into low-risk group(n=22,APACHEⅡscore lower than 10 points),middle-risk group(n=43,APACHEⅡscore of 10~20 points)and high-risk group(n=25,APACHEⅡscore higher than 20 points).30 healthy people who underwent physical examination during the same period were enrolled as control group.After 3 follow-up months,according to different prognosis,they were divided into survival group(n=53)and death group(n=37).The levels of serum CD40L,VCAM-1 and sTREM-1 were detected.Their evaluation value for prognosis was analyzed by ROC curves.Results The levels of serum CD40L,VCAM-1 and sTREM-1 were the highest in high-risk group,followed by middle-risk group and low-risk group(P<0.05).The levels of serum CD40L,VCAM-1 and sTREM-1 in death group were higher than those in survival group(P<0.05).Multivariate Logistic regression analysis showed that levels of serum CD40L,VCAM-1 and sTREM-1 were the risk factors of prognosis in severe pneumonia patients(P<0.05).ROC curve analysis showed that the sensitivity and specificity of serum CD40L combined with VCAM-1 and sTREM-1 for predicting prognosis were higher than those of single index(P<0.05).Conclusion The more severe the patients with severe pneumonia,the higher the levels of serum CD40L,VCAM-1 and sTREM-1,which are the risk factors of prognosis and can be applied as reference indexes to determine conditions and evaluate prognosis.
作者
陈静
孙建
冯晓丽
潘彬
邓清洋
CHEN Jing;SUN Jian;FENG Xiaoli;PAN Bin;DENG Qingyang(The First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China)
出处
《北华大学学报（自然科学版）》
CAS
2020年第6期775-778,共4页
Journal of Beihua University（Natural Science）
基金
成都医学院第一附属医院院内基金课题(CYFY2018GLPHX01).
关键词
重症肺炎
CD40配体
血管细胞黏附分子-1
可溶性髓系细胞触发受体-1
病情
预后
severe pneumonia
CD40 ligand
vascular cell adhesion molecule-1
soluble triggering receptor expressed on myeloid cells-1
condition
prognosis
